Irish Medical Organisation

Editorial - Medical Independent 25th August 2011

Be the squeaky wheel

I am a firm believer that there is strength in numbers. There are approximately 4,500 NCHDs working in the health system. That’s a pretty powerful number, one that should be able to wield quite a bit of influence. Add that to the fact that NCHDs are pretty much the main group saving our hospital system from total collapse and you have, at least theoretically, a rather intimidating force.

Unfortunately, on the ground, this does not seem to be the view of the Department of Health, the HSE or hospital managers. Despite their numbers and contribution to the system, NCHDs appear to continually get the short end of the stick. Even with the introduction of the EU Working Time Directive, few NCHDs are being afforded their legal rights to reasonable working hours. And although the Molloy Deal guaranteed overtime pay, many hospitals are still stalling payment. In the wake of a very expensive recruitment drive in Pakistan and India, NCHDs remain in short supply and as a result, are being forced to work more hours, which they are legally prohibited from doing and often don’t get paid for. And then there is the latest kick in the teeth – no locum cover for annual leave, educational leave, maternity leave.

They say that history moves in cycles. This particular cycle in NCHD history is reminiscent of the pre-Molloy Deal period when NCHDs finally said enough is enough, and demanded to be treated with decency and dignity by their employers. Unfortunately, though, there is one glaring difference between now and then. In the years leading up to the 1997 contract, NCHDs emerged as a cohesive, focused and determined group. NCHD meetings were held frequently in virtually every teaching hospital in the country, allowing junior doctors in each centre to draw up a clear and comprehensive list of issues. At preceding IMO AGMs, the national NCHD meetings were the best attended of all four craft group meetings and the proceedings were heated and well-informed.

This time there is distinctly less cohesiveness among junior doctors. Perhaps the pressures of the working day simply leave young medics with little time or energy for a fight. Perhaps there is a perception that nothing will change anyway. Perhaps there is a fear that raising a head above the parapet will adversely affect future career prospects. The first point is completely understandable. With all that is expected of our most junior medical professionals these days, it’s a wonder they have the energy to eat. On the second point, I would urge all NCHDs to educate themselves on the 1997 contract negotiations and the IMO’s success in securing overtime pay for NCHDs – something that had long been seen as elusive then as a job in construction is now. And on the third point, I give you Prof Sean Tierney, Dr Trevor Duffy, Dr Ronan Boland and the dozens of other former NCHD activists who have climbed up the ranks.

The IMO recently launched its ‘Engage for Change’ campaign to unite NCHDs – both members and non-members – in an effort to create that strength of numbers that is required to effect real change. This is an opportunity for NCHDs to once again say ‘enough is enough: We sat around a table and negotiated a contract of employment to which all parties agreed, we are not asking for salary increases, we are not asking for additional benefits. We are demanding that NCHDs are shown the same respect that is afforded to all other staff groups in the health services and we demand that the terms and conditions that were agreed in our contracts are honoured.’

The IMO is currently holding a series of NCHD meetings in hospitals around the country to highlight the campaign. The meetings are open to IMO members and non-members. Even if you are not a member of the union, even if you are not a supporter of the union, I would encourage all NCHDs to use this opportunity to unite and create an army of foot soldiers that the Department and the HSE can no longer ignore.

Dawn O'Shea

Editor - Medical Independent

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